| Objective: to observe and discuss continuous femoral nerve block and word injection of femoral nerve block for postoperative analgesia effect of total knee arthroplasty,and the influence of early functional rehabilitation,so as to provide reference for clinical to choose the right means of analgesia.Methods: A total of 60 patients initially undergoing unilateral TKA in our hospital from January 2016 to December 2017 were enrolled in this study.Their gender,age,BMI,visual analogue scale(VAS)and range of motion were recorded.All patients were randomly divided into the CFNB group(group A,30 cases)and the SFNB group(group B).Both groups used multimodal analgesia.Anesthesia time,operation time,duration of tourniquet use and dosage of sufentanil citrate and remifentanil hydrochloride injection were recorded during the operation.Adverse reactions and complications were recorded postoperatively.VAS values on the 1d,2d,3d,and 5d after operation were recorded,respectively;the level of pain during functional exercises on the 1d,2d,3d,and 5d was assessed as mild-level(VAS value 0-3),moderate-level(VAS value 4-7)and severe-level(VAS value 8-10),with the use of which the number of patients with different levels of pain in both groups was compared;ROM on the 1d,2d,3d,and 5d was measured postoperatively for the affected side of patients to assess functional rehabilitation;blood routine and level of inflammatory markers(ESR,CRP)in both groups on the 1d,2d,3d,and 5d postoperatively were detected.All data were analyzed by SPSS22.0.Statistical analysis was performed with X2 test.Recorded data was represented by X±S.Comparison between the two groups was conducted with t test.P<0.05 was considered statistically significant.Results: 1.There was no significant difference between group A and group B with respect to the gender,age,BMI,anesthesia time,operation time,duration of tourniquet use,dosage of sufentanil citrate and remifentanil hydrochloride injection during operation,adverse postoperative reactions and complications(P>0.05).2.The VAS values on the 1d,2d,and 3d in group A were 2.47±1.332,2.80±1.375,and 3.32±0.961,respectively,which were significantly lower than those in group B(2.93±1.251,3.30±1.664,and 3.56±1.167).The difference in VAS values between the two groups was statistically significant(p<0.05).3.The ROM values of group A on the 1d,2d,and 3d were 22.15±6.399,30.23±6.017,and 42.17±7.507,respectively,which were lower than those in group B(28.67±5.561,37.27±4.097,49.15±5.309).It is suggested that ROM values of patients in both groups increased significantly with time;at the same time point,the level of knee flexion in group A was significantly lower than that in group B(p<0.05).4.On the 1d postoperatively,group A had 27 mild-level patients and 3 moderate-level patients,and group B had 22 mild-level patients and 8 moderate-level patients.On the 2d postoperatively,group A had 25 mild-level patients and 5 moderate-level patients,and group B had 21 mild-level patients and 9 moderate-level patients.On the 3d postoperatively,group A and group B had 30 and 28 mild-level patients,separately,and 0 and 2 moderate-level patients,respectively.No severe-level patients were found in either group.5.There was no significant difference in VAS and ROM values between the two groups(P>0.05).6.The difference in blood routine,ESR and CRP between the two groups was not statistically significant(p>0.05).Conclusion: 1.Compared with a single femoral nerve block,continuous femoral nerve block has an obvious analgesic effect after TKA.2.In terms of early functional rehabilitation of the knee joint after TKA,a single femoral nerve block was more effective than continuous femoral nerve block.3.In the multimodal analgesic mode,the single femoral nerve block is simple,safe,and highly accepted by patients.It is beneficial to early functional rehabilitation of the knee joint and is worth generalizing. |
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